Ortiz Javier U, Torres Ximena, Eixarch Elisenda, Bennasar Mar, Cruz-Lemini Monica, Gómez Olga, Lobmaier Silvia M, Martínez Josep M, Gratacós Eduard, Crispi Fatima
BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany.
Fetal Diagn Ther. 2018;44(4):305-310. doi: 10.1159/000485380. Epub 2018 Jan 19.
To evaluate left myocardial performance index (MPI) and time intervals in fetuses with twin-to-twin transfusion syndrome (TTTS) before and after laser surgery.
Fifty-one fetal pairs with TTTS and 47 uncomplicated monochorionic twin pairs were included. Left ventricular isovolumetric contraction time (ICT), ejection time (ET), and isovolumetric relaxation time (IRT) were measured using conventional Doppler.
Recipients showed prolonged ICT (46 ± 12 vs. 31 ± 8 vs. 30 ± 5 ms; p < 0.001) and IRT (51 ± 9 vs. 43 ± 8 vs. 43 ± 5 ms; p < 0.001) and higher MPI (0.57 ± 0.12 vs. 0.47 ± 0.09 vs. 0.44 ± 0.05; p < 0.001) than donors and controls. Donors showed shorter ET than recipients and controls (157 ± 12 vs. 169 ± 10 vs. 168 ± 10 ms; p < 0.001) and higher MPI than controls (0.47 ± 0.09 vs. 0.44 ± 0.05; p = 0.006). Preoperative MPI changes were observed in all TTTS stages. Time intervals partially improved after surgery.
Donor and recipient twins had higher MPI due to different changes in the time intervals, possibly reflecting the state of hypovolemia in the donor and hypervolemia and pressure overload in the recipient.
评估激光手术前后双胎输血综合征（TTTS）胎儿的左心室心肌性能指数（MPI）和时间间期。
纳入51对患有TTTS的胎儿和47对无并发症的单绒毛膜双胎。使用传统多普勒测量左心室等容收缩时间（ICT）、射血时间（ET）和等容舒张时间（IRT）。
受血儿的ICT（46±12 vs. 31±8 vs. 30±5毫秒；p<0.001）和IRT（51±9 vs. 43±8 vs. 4 + 5毫秒；p<0.001）延长，且MPI高于供血儿和对照组（0.57±0.12 vs. 0.47±0.09 vs. 0.44±0.05；p<0.001）。供血儿的ET短于受血儿和对照组（157±12 vs. 169±10 vs. 168±10毫秒；p<0.001），且MPI高于对照组（0.47±0.09 vs. 0.44±0.05；p = 0.006）。在所有TTTS阶段均观察到术前MPI变化。手术后时间间期部分改善。
由于时间间期的不同变化，供血儿和受血儿双胎的MPI较高，这可能反映了供血儿的血容量不足以及受血儿的血容量过多和压力超负荷状态。
